Fixes to support better hypotension flow.

input/cql/AdverseEvents.cql

@@ -53,7 +53,7 @@ define "Treated Rationale Combined Data":
   "Treated Rationale" + '|' + "Treated Suggestions" + '|' + "Selection Behavior" + '|' + "Links"
 
 define "Treated Rationale":
-  'A side effect associated with blood pressure management has been detected and addressed: <strong>' + Combine("Contact Suggestion String"("Treated Adverse Events"), ', ') + '</strong>. If event recurs, adjustment to medication and/or blood pressure goal may be required.'
+  'A side effect associated with blood pressure management has been detected and addressed: <strong>' + Combine("Contact Suggestion String"("Treated Adverse Events"), ', ') + '</strong>. If event recurs, adjustment to medication and/or blood pressure goal may be required. This message may remain for up to 30 days as a reminder to continue monitoring this condition.'
 
 define "Treated Suggestions":
   '[]'

input/cql/HypertensiveEmergency.cql

@@ -26,7 +26,8 @@ define "Two High BPs":
   "BP Within 14 Days"("Next Most Recent BP Reading") and Common."HTN Crisis BP"("Next Most Recent BP Reading")
 
 define "Two Low BPs":
-  Common."HTN Low Crisis" and Common."HTN Low Crisis BP"("Next Most Recent BP Reading")
+  Common."HTN Low Crisis" and "BP Within 14 Days"(Common."Most Recent BP Reading") and 
+  "BP Within 14 Days"("Next Most Recent BP Reading") and Common."HTN Low Crisis BP"("Next Most Recent BP Reading")
 
 define "Recommendation":
   'Blank.Summary'

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Condition/condition-AE-LowOfficeBPs-1.json

@@ -0,0 +1,52 @@
+{
+  "resourceType": "Condition",
+  "id": "condition-AE-LowOfficeBPs-1",
+  "note": [
+    {
+      "text": "Indicates Preexisting Diagnosis of Hypertension"
+    }
+  ],
+  "category": [
+    {
+      "coding": [
+        {
+          "system": "http://terminology.hl7.org/CodeSystem/condition-category",
+          "code": "problem-list-item",
+          "display": "Problem List Item"
+        }
+      ],
+      "text": "Problem List Item"
+    }
+  ],
+  "clinicalStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
+        "code": "active"
+      }
+    ]
+  },
+  "verificationStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
+        "code": "confirmed"
+      }
+    ]
+  },
+  "code": {
+    "coding": [
+      {
+        "system": "http://snomed.info/sct",
+        "code": "59621000",
+        "display": "Hypertension"
+      }
+    ],
+    "text": "Hypertension"
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "onsetDateTime": "2017-02-20T15:16:21-05:00",
+  "recordedDate": "2017-02-20T15:16:21-05:00"
+}

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Condition/condition-AE-LowOfficeBPs-2.json

@@ -0,0 +1,52 @@
+{
+  "resourceType": "Condition",
+  "id": "condition-AE-LowOfficeBPs-2",
+  "note": [
+    {
+      "text": "Indicates An Adverse Reaction that Could be Related to Medications"
+    }
+  ],
+  "category": [
+    {
+      "coding": [
+        {
+          "system": "http://terminology.hl7.org/CodeSystem/condition-category",
+          "code": "encounter-diagnosis",
+          "display": "Encounter Diagnosis"
+        }
+      ],
+      "text": "Encounter Diagnosis"
+    }
+  ],
+  "clinicalStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
+        "code": "active"
+      }
+    ]
+  },
+  "verificationStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
+        "code": "confirmed"
+      }
+    ]
+  },
+  "code": {
+    "coding": [
+      {
+        "system": "http://hl7.org/fhir/sid/icd-10-cm",
+        "code": "N17.0",
+        "display": "Acute kidney problem"
+      }
+    ],
+    "text": "Acute kidney problem"
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "onsetDateTime": "2023-11-19T15:16:21-05:00",
+  "recordedDate": "2023-11-19T15:16:21-05:00"
+}

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Condition/condition-AE-LowOfficeBPs-3.json

@@ -0,0 +1,52 @@
+{
+  "resourceType": "Condition",
+  "id": "condition-AE-LowOfficeBPs-3",
+  "note": [
+    {
+      "text": "Indicates An Adverse Reaction that Could be Related to Medications"
+    }
+  ],
+  "category": [
+    {
+      "coding": [
+        {
+          "system": "http://terminology.hl7.org/CodeSystem/condition-category",
+          "code": "encounter-diagnosis",
+          "display": "Encounter Diagnosis"
+        }
+      ],
+      "text": "Encounter Diagnosis"
+    }
+  ],
+  "clinicalStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
+        "code": "active"
+      }
+    ]
+  },
+  "verificationStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
+        "code": "confirmed"
+      }
+    ]
+  },
+  "code": {
+    "coding": [
+      {
+        "system": "http://snomed.info/sct",
+        "code": "32834005",
+        "display": "Brief loss of consciousness"
+      }
+    ],
+    "text": "Brief loss of consciousness"
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "onsetDateTime": "2023-11-19T15:16:21-05:00",
+  "recordedDate": "2023-11-19T15:16:21-05:00"
+}

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Goal/goal-AE-LowOfficeBPs-1.json

@@ -0,0 +1,61 @@
+{
+  "resourceType": "Goal",
+  "id": "goal-AE-LowOfficeBPs-1",
+  "lifecycleStatus": "active",
+  "achievementStatus": {
+    "coding": [
+      {
+        "system": "http://terminology.hl7.org/CodeSystem/goal-achievement",
+        "version": "4.0.1",
+        "code": "in-progress",
+        "display": "In Progress"
+      }
+    ]
+  },
+  "statusDate": "2023-08-05",
+"startDate": "2023-08-05",
+  "description": {
+    "text": "Goal of 135/85"
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "target": [
+    {
+      "measure": {
+        "coding": [
+          {
+            "system": "http://loinc.org",
+            "version": "2.68",
+            "code": "8480-6",
+            "display": "Systolic blood pressure"
+          }
+        ]
+      },
+      "detailQuantity": {
+        "value": 135,
+        "unit": "mmHg",
+        "system": "http://unitsofmeasure.org",
+        "code": "mm[Hg]"
+      }
+    },
+    {
+      "measure": {
+        "coding": [
+          {
+            "system": "http://loinc.org",
+            "version": "2.68",
+            "code": "8462-4",
+            "display": "Diastolic blood pressure"
+          }
+        ]
+      },
+      "detailQuantity": {
+        "value": 85,
+        "unit": "mmHg",
+        "system": "http://unitsofmeasure.org",
+        "code": "mm[Hg]"
+      }
+    }
+  ]
+}

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Observation/observation-AE-LowOfficeBPs-1.json

@@ -0,0 +1,29 @@
+{
+  "resourceType": "Observation",
+  "id": "observation-AE-LowOfficeBPs-1",
+  "status": "final",
+  "note": [
+    {
+      "text": "Patient is female and has more than 2 drinks a day. Refer to counseling."
+    }
+  ],
+  "code": {
+    "coding": [
+      {
+        "system": "http://loinc.org",
+        "version": "2.69",
+        "code": "11287-0",
+        "display": "Alcoholic drinks per drinking day - Reported"
+      }
+    ]
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "effectiveDateTime": "2023-06-20T10:00:00-07:00",
+  "issued": "2023-06-20T00:00:00-07:00",
+  "valueQuantity": {
+    "value": 4.1,
+    "unit": "Drinks/Day"
+  }
+}

input/tests/plandefinition/AdverseEvents/AE-LowOfficeBPs/Observation/observation-AE-LowOfficeBPs-2.json

@@ -0,0 +1,82 @@
+{
+  "resourceType": "Observation",
+  "id": "observation-AE-LowOfficeBPs-2",
+  "status": "final",
+  "note": [
+    {
+      "text": "Home Blood Pressure Reading"
+    }
+  ],
+  "extension": [
+    {
+      "url": "http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt",
+      "valueCoding": {
+        "system": "http://snomed.info/sct",
+        "code": "264362003"
+      }
+    }
+  ],
+  "category": [
+    {
+      "coding": [
+        {
+          "system": "http://terminology.hl7.org/CodeSystem/observation-category",
+          "code": "vital-signs",
+          "display": "vital-signs"
+        }
+      ]
+    }
+  ],
+  "code": {
+    "coding": [
+      {
+        "system": "http://loinc.org",
+        "code": "55284-4",
+        "display": "Blood Pressure"
+      }
+    ],
+    "text": "Blood Pressure"
+  },
+  "subject": {
+    "reference": "Patient/AE-LowOfficeBPs"
+  },
+  "effectiveDateTime": "2023-02-19T15:16:21-05:00",
+  "component": [
+    {
+      "code": {
+        "coding": [
+          {
+            "system": "http://loinc.org",
+            "code": "8462-4",
+            "display": "Diastolic Blood Pressure"
+          }
+        ],
+        "text": "Diastolic Blood Pressure"
+      },
+      "valueQuantity": {
+        "value": 98.52660352979804,
+        "unit": "mm[Hg]",
+        "system": "http://unitsofmeasure.org",
+        "code": "mm[Hg]"
+      }
+    },
+    {
+      "code": {
+        "coding": [
+          {
+            "system": "http://loinc.org",
+            "code": "8480-6",
+            "display": "Systolic Blood Pressure"
+          }
+        ],
+        "text": "Systolic Blood Pressure"
+      },
+      "valueQuantity": {
+        "value": 150.65064054117963,
+        "unit": "mm[Hg]",
+        "system": "http://unitsofmeasure.org",
+        "code": "mm[Hg]"
+      }
+    }
+  ]
+}